Patterns of change in mental health status during the first two years of spousal bereavement

Abstract

The pattern of change in mental health status over 24 months of bereavement was studied using a cohort sequential design with 118 widowed who experienced the death of a spouse within the past 18 months. In order to identify the pattern of change in spousal bereavement, observed mean score changes in mental health were calculated for the three time frames when data were collected starting at 3 months and concluding at 24 months. Logarithmic transformation of data points were used to predict mental health status for each participant at 24 months post bereavement. Results indicated a consistent pattern of improvement in overall mental health starting at 3 months, peaking at 15 months, slightly declining over the next 6 months, followed by an upward trend again at 24 months. The overall pattern of change was similar to the psychotherapy dosage model in which time and other factors (e.g., psychotherapy, group participation, and personal resources) contribute to the natural course of recovery during bereavement. The improvement in bereaved individuals followed a similar pattern to that observed in the psychotherapy phase model; dramatic change in the domain of well-being followed by symptom alleviation. Unlike, the psychotherapy model, the pattern of change in functioning remained unchanged and within a normal range throughout the 2 years. Comparisons between the pattern of change for complicated and uncomplicated grievers indicated significant differences in overall mental health, well-being, symptoms, and functioning throughout the first 18 months. Using criteria for clinically significant change, 73.7% of participants were improved, an additional 14.91% met the criteria for reliable change, and 11.39% did not improve.